Purpose :
Telepresence allows a remote physician full access to screening data in real time. To determine the accuracy of a novel system for teleglaucoma during community eye screenings and compare outcomes to standard on-site assessment.

Methods :
Thirty-four subjects were selected from community outreach screenings conducted according to a predefined, published protocol that included demographics, ocular and systemic history, visual acuity, tonometry, anterior and posterior segment imaging. A Canon CR-2 Plus AF digital, non-mydriatic fundus camera with a resolution of 18 Mp and Fundus Autofluorescence (FAF) capabilities was used. Imaging was conducted in a dimly lit room to prevent inclusion of artifacts. Optic nerve vertical and horizontal cup-to-disc ratio, presence of signs of glaucomatous neuropathy (disc hemorrhage, asymmetry in cup-to-disc ratio, other) were assessed. An analysis software, TeamViewer (Florida, USA) was used for remote access to patient data and images. A glaucoma fellowship-trained physician performed diagnostic and therapeutic recommendations twice on separate days and in a different, random order: remotely by telepresence through TeamViewer in real-time and on-site by physical presence at the screening station. Data regarding the accuracy of diagnostic tests (vertical and horizontal C/D ratio) and follow-up recommendations (<1m, 1-3 month, 1 year follow-up) from telepresence and physical presence were then compared. The Intra-class correlation coefficient (ICC) was used for analysis of measured outcomes.

Conclusions :
Telepresence in the diagnosis and management recommendations of glaucoma was successful, accurate and highly correlated with on-site physical presence findings and recommendations. Application of telepresence during screenings in glaucoma and in other vision-threatening diseases, warrants a larger study that can encompass additional imaging technologies such as SD-OCT and OCT-A.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.